title: Reduced abuse, therapeutic errors, and diversion following reformulation of extended-release oxycodone in 2010.
abstract: This study evaluated changes in abuse exposures, therapeutic error exposures, and diversion into illegal markets associated with brand extended-release oxycodone (ERO) following introduction of reformulated ERO. Original ERO and reformulated ERO street prices also were compared. Data from the Poison Center and Drug Diversion programs of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System were used. Quarterly rates 2 years prior to introduction of reformulated ERO (October 2008 through September 2010) were compared to quarterly rates after introduction (October 2010 through March 2012) using negative binomial regression. Street prices were compared using a mixed effects linear regression model. Following reformulated ERO introduction, poison center ERO abuse exposures declined 38% (95% confidence interval [CI]: 31-45) per population and 32% (95% CI: 24-39) per unique recipients of dispensed drug. Therapeutic error exposures declined 24% (95% CI: 15-31) per population and 15% (95% CI: 6-24) per unique recipients of dispensed drug. Diversion reports declined 53% (95% CI: 41-63) per population and 50% (95% CI: 39-59) per unique recipients of dispensed drug. Declines exceeded those observed for other prescription opioids in aggregate. After its introduction, the street price of reformulated ERO was significantly lower than original ERO.
  
  
  CONCLUSIONS
  This article indicates that the abuse, therapeutic errors, and diversion of ERO declined following the introduction of a tamper-resistant reformulation of the product. Reformulating abused prescription opioids to include tamper-resistant properties may be an effective approach to reduce abuse of such products.
authors.affiliation: Denver Health and Hospital Authority/Rocky Mountain Poison and Drug Center, Denver, Colorado. Electronic address: Geoff.Severtson@rmpdc.org.
authors.forename: Stevan Geoffrey
authors.initials: SG
authors.lastname: Severtson
authors.forename: Becki Bucher
authors.initials: BB
authors.lastname: Bartelson
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Davis
authors.forename: Alvaro
authors.initials: A
authors.lastname: Muñoz
authors.forename: Michael F
authors.initials: MF
authors.lastname: Schneider
authors.forename: Howard
authors.initials: H
authors.lastname: Chilcoat
authors.forename: Paul M
authors.initials: PM
authors.lastname: Coplan
authors.forename: Hilary
authors.initials: H
authors.lastname: Surratt
authors.forename: Richard C
authors.initials: RC
authors.lastname: Dart
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000191:economics; D002626:Chemistry, Pharmaceutical; D003365:Costs and Cost Analysis; D003692:Delayed-Action Preparations; D016527:Drug Costs; D004335:Drug and Narcotic Control; D006801:Humans; D013287:Illicit Drugs; D008137:Longitudinal Studies; D008508:Medication Errors / Q000706:statistics & numerical data*; D010098:Oxycodone / Q000008:administration & dosage / Q000191:economics; D011039:Poison Control Centers; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D013287:Illicit Drugs; D010098:Oxycodone
keywords: Epidemiology; diversion; extended-release oxycodone abuse; reformulation; therapeutic error